Surgical Outcomes and Prognostic Factors of Traumatic Retinal Detachment at a Tertiary Hospital in Northern Tanzania

Abstract

Aim: To assess surgical outcomes and prognostic factors for traumatic retinal detachment following globe injuries among patients treated at a tertiary hospital in Northern Tanzania from December 2012 to November 2022. Study Design: A hospital based retrospective cohort study. Place and Duration of Study: Department of ophthalmology, Kilimanjaro Christian Medical Centre in Northern Tanzania between December 2012 to November 2022. Methodology: Retrospective review of files of 80 patients who had undergone retinal detachment surgery following globe injury, and were monitored for a minimum of 3 months between December 2012 and November 2022. Collected data encompassed demographics, initial visual acuity (VA), type and cause of the injury, clinical observations, surgical procedures performed, postoperative retinal status, and final best corrected visual acuity (BCVA). Statistical analysis involved the use of generalized linear model with family Poisson distribution and log link function. Results: Among 80 study participants, 68 (85%) were males, the median age 30 (17.5-38) years, with the largest group of participants being workers (34, 42.5%). Twenty-seven patients (33.75%)            had an unrecorded cause of injury, while vegetative and metallic were 17 (21.25%) and 15 (18.75%), respectively. Fifty-five patients (68.8%) had close globe injury, with the median duration of injury and symptoms being 105 (48.5-365) days & 90 (30-240) days, respectively. Anatomical success and functional success were achieved in 62 (77.5%) and 34 (42.5%), respectively. The predictor for a poor anatomical outcome was the presence of pre-operative proliferative vitreoretinopathy (PVR), while an increase in age was associated with functional success, but macula involvement and the presence of pre-operative PVR were associated with a poor functional outcome. Conclusion: Factors like advancing age, proliferative vitreoretinopathy, and macular status influence surgical outcomes. The proportion of visual success was lower than anatomical success, highlighting the challenge of restoring vision even after successful retinal reattachment.